Newborn Nectar

By Karen SteinkePosted on May 22, 2018

Mother’s own milk is proving to be the best medicine for low-weight preemies.

Rachael feeding her daughter Adaline her own breast milk

The clock read 11 p.m. and as exhausted new mom Rachael sat alone in her daughter Adaline’s nursery, fighting to stay awake while pumping breast milk for the eighth time that day, she stopped for a moment and wondered why she was doing it. Baby Adaline, a preemie who is doing well and almost ready to come home, has spent the last 2½ months in the Johns Hopkins All Children’s neonatal intensive care unit (NICU) building up her strength.

Adaline was born at a mere 1 pound, 8 ounces, just under 25 weeks. Between the incubator, a jumble of wires and tubes orbiting her and the obvious concern with her miniscule size, the magical, one-of-a-kind intimacy of breast feeding between mother and child wasn’t meant to be at that time for Rachael and Adaline.

Unfortunately, that opportunity is lost for many mothers with extremely-low-birth-weight babies.

Low-birth-weight Babies Thrive with Mother’s Milk

The irony, unknown to many, is that researchers at Johns Hopkins All Children’s Hospital are discovering that it’s the low-birth-weight babies who especially benefit from mother's own milk. They are vulnerable to illnesses and most prone to infections, and breastfeeding helps combat all of that.

“Mother’s milk is more than a source of nutrition for babies—it is rich in hundreds, possibly thousands of molecules that have a positive effect on health. These benefits occur not only in infancy but last a lifetime,” explains Melanie Newkirk, clinical manager of Nutritional Services, Lactation and the Milk Depot at Johns Hopkins All Children’s NICU. In addition to carbohydrates, protein and fats to support growth, mother’s own milk contains immune enhancing molecules, growth factors, hormones, enzymes and antimicrobial agents. Donor milk from other mothers is the second best option.

“Premature babies are especially vulnerable to illnesses caused by early birth,” Newkirk continues. “They have underdeveloped organ systems including the gastrointestinal tract, lungs and brain. They are born with limited immune function so they are prone to infections. It is known that the antibodies in mother’s own milk protects premature babies from these, often serious, complications like no known medicine can, often through the benefits of gut bacteria."

Gut Bacteria: Better Than it Sounds

Gut microbiota doesn’t sound terribly appealing, but good bacteria passed from the mother to the infant during the birthing process and through mother’s milk is proving to help the baby’s immune system, says Prabhu Parimi, M.D., director of the Johns Hopkins All Children’s Maternal, Fetal & Neonatal Institute.

Parimi is working closely with Newkirk and others in the institute to initiate cohorts—groups with similar medical conditions—that will help show other ways that mother’s own milk is helping low-birth-weight babies thrive. One of the cohorts is aiming to show what Parimi already believes—mother’s milk is helping babies’ brain-health long term.

“We already see the connection between the gut and the brain," Parimi explains. "We are investigating ways to improve the baby’s immune system to counter infections. But it doesn’t stop there. The benefits of mother’s milk are endless. It is also proving to decrease lung disease, another issue that frequently shows up in low-birth-weight babies like Adaline.” Parimi is conducting his own studies and working closely with Johns Hopkins Medicine colleagues on campuses in Baltimore to compare notes.

Adaline’s mother, Rachael, who happens to be a nurse educator at Johns Hopkins All Children’s, has learned much about the benefits of mother’s own milk. “Look, pumping is exhausting,” she explains. “When you can’t breastfeed, you are pumping instead—eight times a day. I’ve done the math, Adaline is almost 3 months old and I’ve completed 496 pumping sessions at about 1 hour each. I kept asking myself, ‘Why am I doing this,’” she asks with a laugh. Then she gets serious and takes a breath.

“When you have a child that is hospitalized, there are few things you have control of,” she says, lost in the memory. “The only thing that is in my control is my ability to provide the milk that is going to help improve her life and her health. No one can do that for her except me. That’s very empowering. And it keeps me going on those nights when I’d love to hit the pillow instead.”

“The only thing that is in my control is my ability to provide the milk that is going to help improve her life and her health. No one can do that for her except me. That’s very empowering.” – Adaline’s mom, Rachael

As a nurse herself, Rachael knew more than average about the benefits of mother’s milk, but even she learned from “the lactation consultants, nurses and the medical team, who did an amazing job of presenting the benefits of breastfeeding and pumping to me. That includes improving Adaline’s immunity, reducing the risk of SIDS, reducing the risk of obesity, decreasing gastrointestinal issues, bonding, helping to learn baby’s cues,” she adds. “It goes on and on. Mother’s milk helps all babies, but it does wonders for low-birth-weight babies. I appreciated the fact that, while the hospital did its job of educating me—and all the mothers here—we were still given the freedom to make the best decision to pump over formula for ourselves and our situations. I appreciated that.”

Johns Hopkins All Children’s NICU and the Maternal, Fetal & Neonatal Institute offer a strong support system for pumping moms including lactation consultants, bedside nurses, neonatologists, nutritionists and others who help mothers be successful with pumping. Moms can meet other moms and consult with experts in weekly iPump Club meetings. And the Milk Depot offers pumping supplies and milk storing facilities.

Education is key to convincing mothers of the importance of mother’s milk—even if the only option is pumping—and Newkirk is finding that once moms understand the importance of their role, they are often willing to provide as much of their own milk as they can.“Research tells us that any mother’s milk helps the baby and more is better,” Newkirk explains. “We want our NICU mothers, fathers and their extended support system to understand the importance of mother’s milk.

As for Adaline, today she is nearly 5 pounds and her chronic lung disease is manageable enough to have her mostly breathing on her own. She is almost ready to go home where Rachael looks forward to the opportunity of actually breastfeeding Adaline in the calm of her beautiful, and so far unused, nursery.

“Science is telling us that mother’s milk is setting off a chain reaction of better health that lasts a lifetime for these babies,” Newkirk concludes. “Brain function, gut health, stronger lungs, better test scores and school performance all benefit.”